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5 - Pharmacology > Hypertension > Flashcards

Hypertension Flashcards

1
Q

Give some non-pharmacological risk factors that can avoid the need for drug treatment

A

o Optimum body weight (BMI 20-25 kg/m2)o Regular physical activity (>30 mins a day)o Moderation of alcohol and salt. (

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2
Q

Give the grades for classifying hypertension

A

Grade 1 = 140-159 and 90-99Grade 2 = 160-179 and 100-109Grade 3 = >180 and >110

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3
Q

Give the main classes of antihypertensives

A

ACE inhibitorsAngiotensin antagonistsRenin AntagonistsCa2+ channel blockersThiazidesBeat blockers

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4
Q

Give some ACEi examples

A

RamiprilLisinoprilCaptopril

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5
Q

Give the mechanism for ACEi

A

Antagonise angiotensin converting enzyme, which converts angiontensin 1 to angiotensin 2. Reduces AT2 and aldosterone levels.Causes vasodilation and decreased TPR. Reduces bradykinin breakdown

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6
Q

ADRs of ACEi

A

Dry coughAngiooedemaHypotensionRenal failureHyperkalaemia

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7
Q

Give some angiotensin receptor blockers

A

LosartanValsartan

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8
Q

Mechanism for angiotensin receptor blockers

A

Block angiotensin 2 receptors- angiotensin receptor 1Inhibits vasoconstriction and aldosterone secretion

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9
Q

ADRs for angiotensin receptor blockers

A

Hyperkalaemia Renal failure

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10
Q

Give an example of a thiazide diuretic

A

Bendroflumethazide

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11
Q

Mechanism for thiazide diuretics

A

Antagonises Na-Cl co-transported in DCTBlocks Na+ and H2O reabsorptionLowers blood volume and blood pressure

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12
Q

ADRs of thiazides

A

HypkalaemiaHyperuricaemiaImpaired glucose toleranceHyponatremia, hypermagnesemia, hypercalcaemiaMetabolic alkalosisCholesterol and triglycerides increase

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13
Q

Why do you get hypokalaemia with thiazides?

A

Increased Na+ is reaching the CD where more Na+ is being reabsorbed via ENAC channels. Na+ must then be pumped into the blood via a basolateral Na+/K+ exchanger, leading to more K+ being excreted.

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14
Q

Why do you get metabolic alkalosis with thiazide diuretics?

A

Increased delivery of K+ to CD to allow for uptake of Na+ means that H+ is taken up into cells, due to K+/H+ exchanges, therefore leading to metabolic alkalosis.

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15
Q

Give some beta blockers

A

PropanololAtenololBisoprololSotololMetoprolol

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16
Q

Mechanism for beta blockers

A

Antagonise B-1 receptors in the heart, decreasing chronotropy and inotropy. This causes a decrease in oxygen demand and in the cardiac output. Also inhibits renin release, by decreasing the sympathetic drive.

17
Q

ADRs of beta blockers

A

BronchospasmFatigue and insomniaDizzinessCold extremitiesHypotensionBradycardia

18
Q

Give sone drug interactions that occur with beta antagonists

A

Prevents salbutamol from workingVerapamil also has a negative inotropic action

19
Q

What are the three types of calcium antagonists?

A

DihydropyridinePhenylalkylamineBenzothiazepine

20
Q

Describe dihydropyridine

A

Nifedipine and amlodipine- are 90% protein bound- liver metabolism- good oral absorptionADRS:SNS activationOedemaFlushing, sweating

21
Q

Describe phenylalkylamines

A

Verapamil- prevents Ca2+ transport across myocardial and vascular smooth muscle- class 4 anti-arrthymic agent- peripheral vasodilation and reduced cardiac preload ADRS:constipationBradycardiaWorsen heart failure due to negative inotrophy

22
Q

Describe benzothiazepines

A

Diltiazem- prevents Ca2+ transport across myocardial and vascular smooth muscle- prolongs AP and refractory period- peripheral vasodilation and reduced cardiac preloadADRS:BradycardiaWorsen heart failure due to negative inotrophy

23
Q

Give a direct renin antagonist

A

Aliskiren

24
Q

Mechanism for renin antagonist

A

Prevents action fo renin converting angiontensinogen to angiotensin 1

25
Q

ADRS for renin antagonist

A

Angio-oedemaHyperkalaemiaHypotensionGI disturbances

26
Q

Give some particular characteristics of renin antagonists

A

V. long half lifeMainly eliminated as unchanged compound in the faecesNot metabolised via CYP450

27
Q

What are some combination therapies that are used for hypertension?

A

Diuretic + ACEiDiuretic + beta blocker

5 - Pharmacology (17 decks)

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